clinician user guide - This Way Up

Take Control of Your Wellbeing.

CLINICIAN USER GUIDE Frequently Asked Questions thiswayup.org.au | clinician user guide v2.3

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Contents Who are we?...............................................................................................................................................................3 What is CBT?..............................................................................................................................................................5 What is iCBT?.............................................................................................................................................................5 Why use THIS WAY UP? ........................................................................................................................................6 What clinicians have said about THIS WAY UP.............................................................................................7 What does a course contain?................................................................................................................................8 Getting started ..........................................................................................................................................................9 How you could incorporate THIS WAY UP’s iCBT courses in your clinical practice ..................... 11 Who is suitable for a THIS WAY UP Course? .............................................................................................. 11 What if it would be awkward for me to treat this patient? ..................................................................... 12 Can I choose which course my patient will complete? ............................................................................. 12 Are there any costs involved? ........................................................................................................................... 12 How can I view my patient/client’s progress? ............................................................................................. 12 What are the technical requirements? .......................................................................................................... 13 Where can I get more information? ................................................................................................................ 13

thiswayup.org.au | clinician user guide v2.3

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Who are we? THIS WAY UP was jointly designed and developed by Professor Gavin Andrews from the University of New South Wales, and his team of psychiatrists and clinical psychologists, at St Vincent’s Hospital, Sydney. As a non-profit initiative, THIS WAY UP is funded by the Australian Government and the Clinical Research Unit for Anxiety and Depression (CRUfAD) at St Vincent’s Hospital, Sydney. THIS WAY UP offers internet-based courses that can be prescribed by a GP or other health professional or suggested as self-help courses, including: Prescription or Self-Help (paid courses)

Self-Help Only* (free of charge)

Prescription Only (paid courses)

Depression (English or Chinese)

TeenSTRONG

Insomnia

Generalised Anxiety Disorder

Posttraumatic Stress Disorder (PTSD)

Intro To Mindfulness

Mixed Depression and Anxiety

Mindfulness-Based Course for Mixed Depression and Anxiety

Coping With Stress

Obsessive Compulsive Disorder

Chronic Pain (Reboot)

Panic Disorder Social Phobia Health Anxiety

*Please note, self-help courses cannot be prescribed nor supervised.

Our web-based courses are optimised for desktop or laptop use. The following courses are also available as mobile phone apps but can only be done as self-help, not supervised: Depression (English), GAD, Mixed, OCD, Panic, and Social Phobia.


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What is CBT? Our courses are based on the effective CBT model. CBT is the goldstandard psychological intervention for treating anxiety and depression and emphasises the relationship between thoughts, feelings and behaviours in creating change. The evidence-based CBT treatment courses that we offer have been developed from a large amount of research, which indicates that CBT is effective in treating anxiety and depression. You can read more about CBT on our website page about CBT: https://thiswayup.org.au/how-we-can-help/cognitive-behavioural-therapy/ We also have a free training course for clinicians where you can learn about CBT principles and practices https://thiswayup.org.au/returning-clinicians/cognitive-behavioural-therapy/

What is iCBT? iCBT is CBT that is delivered via the internet. It is also known as internet-delivered CBT, online CBT, computerised CBT, CCBT, or eCBT. THIS WAY UP iCBT courses have the same content as therapy with a clinician (face-to-face). However, there are some major differences between iCBT and its traditional counterpart, including; CBT • • • • • • • •

iCBT Face-to-face 5-20 sessions on average Structured around the expectations and needs of the client (low fidelity) Considerable out of pocket cost Ongoing clinical support Limited geographical availability May require referrals and recommendations Potential for long waiting times


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Online 4-10 lessons on average Clinically proven structure to optimise treatment (high fidelity) Low, fixed cost Option of clinical support, or selfmotivated therapy Available in all internet connected areas Easily prescribed

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Immediate access

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Why use THIS WAY UP? This Way Up is the only iCBT system in Australia that helps clinicians to keep track of their patient’s progress with immediate feedback after a patient completes online questionnaires and lessons. When you login to your account, you would be able to review the patients’ distress scores and see if they are improving. Supported by a wealth of research, our evidence-based courses have been shown to be effective in the treatment of anxiety and depression. For a list of all our published research, please click here. There are many benefits of our courses to your patients, including;  Convenience: our courses can be completed from home and outside of working hours.  Low-cost: the entire course costs less than one visit to a psychologist or psychiatrist.  Immediate-access: There are no waiting periods. Patients can get started straight away.  Effective: 80% of people who complete a course will benefit substantially, 50% to the point of no longer being troubled by anxiety or depression. However, 20% will not respond and should be reassessed or referred for a second opinion.


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What clinicians have said about THIS WAY UP “The automated administration and scoring of standardised measures throughout treatment means I can easily track client progress in a much more time-efficient way than administering and scoring the measures myself. The online clinician view lets me see all my client’s scores in one place, all at once.” Psychologist

“I loved receiving an email from a patient who could not afford, or find the time, to see a professional; she was amazed that just from a few simple online lessons, she had learnt the tools to overcome her anxiety.” Clinical Psychologist

“THIS WAY UP’s online services have been hugely useful for my clients and for myself as a clinician. Clients find the material logical, easy to follow and practical; and they appreciate the 24/7 web access.” Clinical Psychologist

“It’s really like having an intern in the practice.” General Practitioner

“My patients tell me they no longer feel they are ‘weird’ or suffering alone. This Way Up courses have a tremendous normalising effect..” Clinical Psychologist

“It’s wonderful! Thanks so much. This gives me more time to work with clients in implementing and learning the skills they need to manage anxiety and depression.” Clinical Psychologist


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What does a course contain? Each course follows the story of a fictional character (or characters) who experience the symptoms of anxiety and/or depression. Throughout the course, the stories will help the patient learn about their own symptoms and the steps required to help them recover. THIS WAY UP courses involve:  6 lessons in an easy-to-read comic-based story format  Homework exercises to complete after every lesson  Extra Resources and descriptions of other peoples’ experiences  Online questionnaires before each lesson

Each lesson takes about 20 minutes to read and will generally require the patient to take 34 hours in between lessons to complete the suggested homework activities. The courses are self-paced, but designed to be completed within 3 months, at most. It is best to do one lesson every week or two to allow time to practice between lessons. There is a 5-day lockout period between lessons to encourage the revision of material and completion of homework activities. Initially the patient will be granted 90 days access, and upon completion of the course, they will be granted an extra 12 months access for practice purposes.


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Getting started This Way Up Clinic is accessed via the Internet and you need to first register. 1.

Register: Clinicians need to register at

www.thiswayupclinic.org/users/clinicianRegistration

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Sign in at www.thiswayupclinic.org/users/login using your registered email address and password.


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Prescribe a course to a patient using our Quickscript system. Your patient will

receive an email from us with a link and instructions on how to sign up for a course, supervised by you.

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Motivate and remind patients to continue their progress: our system will also send automatic reminders and alerts to you and your patient.

Patients need to be aware that they will get the most benefit if they complete the entire course and set aside time to complete the homework activities. Of course, patients do not always do what their doctor or psychologist suggests, even when they know that it will be beneficial to them. This may be because they don’t understand what they need to do. As the prescribing clinician, there are three important roles you can play: 1. Convey to patients that This Way Up Clinic iCBT courses are a very good treatment option 2. Stress the importance of completing the program according to schedule – complete the lessons, practice the homework tasks and regularly implement the skills in their daily life


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3. Take an interest in their progress through telephone or face-to-face follow-up, this will help with keeping them engaged in therapy as well

How you could incorporate THIS WAY UP’s iCBT courses in your clinical practice As a preparation for face-to-face treatment • Patients learn the key CBT skills before their treatment • iCBT can inform them about what therapy involves and set positive and realistic expectations for treatment

As a stand-alone intervention • iCBT has been proven effective as a stand-alone intervention for anxiety disorders and comorbid depression and anxiety

As an adjunct to face-to-face treatment sessions • Patients can do an iCBT lesson either before or immediately after a face-to-face session, or in between sessions

As a relapse prevention tool • When face-to-face treatment has been completed, iCBT can be prescribed to ensure patients are regularly practicing CBT skills • a useful way of monitoring the patient’s for a possible relapse

* Adapted from Newby, J. 2016, How to integrate internet cognitive behavioural therapy within your clinical practice: a practical guide for clinicians.

Who is suitable for a THIS WAY UP Course? Patients who have moderate to severe anxiety and depressive disorder are suitable for a THIS WAY UP course. Please note that THIS WAY UP will not accept clinical responsibility for individuals who:


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Have been diagnosed with schizophrenia, bipolar disorder, or drug or alcohol dependence

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Are suicidal

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Are taking benzodiazepines and/or atypical antipsychotics.

What if it would be awkward for me to treat this patient? There are two options if the clinician does not want to treat this person for whatever reason. •

Clinicians can assess the patient as likely to benefit from a This Way Up Clinic course and refer the patient asking that we assess, prescribe and supervise the patient doing the course. This Way Up staff will take clinical responsibility for the patient as they complete the course and return the patient to the care of the clinician. Simply email [email protected] with the patients email address and name. We’ll be in touch.

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Clinicians can suggest that the patient log on to www.thiswayup.org.au and register to do a self- help course. The cost and content of these courses are identical to the prescribed courses and while automated reminders are active there is no supervision.

Can I choose which course my patient will complete? Yes. You are able to recommend a course for your patient when you prescribe. Please note that the patient/client must also select this course during enrolment to be enrolled in this course.

Are there any costs involved? Each This Way Up Clinic Internet course cost patients AUD$59.00 for 90 days access to their course (a course contains 6 lessons). There are no costs to prescribing clinicians.

How can I view my patient/client’s progress? Your patient’s progress will be emailed to you. However, you can access their progress at any time by logging onto your clinician account. To log in: thiswayup.org.au | clinician user guide v2.3

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1. Go to www.thiswayupclinic.org 2. In the login box enter your email address and password Once logged in you will able to view your patient’s progress scores. If you want to review the course content that you have prescribed to your patient (e.g. view lesson, view homework, testimonials and additional resources). Click and select the patient in the drop down box.

What are the technical requirements? In order to use This Way Up you will need updated standard web browsing software. We recommend using the latest version of Google Chrome https://www.google.com/chrome/browser/desktop/index.html or Mozilla Firefox https://www.mozilla.org/en-US/firefox/new/

Where can I get more information? To find out more about This Way Up Clinic, please browse our website and download the Information Flyer for Clinicians from the Resources section. If you have any further questions, please feel free to contact the This Way Up Clinic team on (02) 8382 1400 or send us an email via our contact page.

Warm wishes, The team from THIS WAY UP, The Clinical Research Unit for Anxiety and Depression Level 4, The O’Brien Centre, St Vincent’s Hospital, Sydney Website: thiswayup.org.au Email: [email protected] Telephone: +61 (02) 8382 1400


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